| NPI | 1225536287 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IRMA CAMPOS President 813-421-2375 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TC0700X Psychologist, Clinical |
| Additional Taxonomies | 103T00000X Psychologist |
| Enumeration Date | 2018-01-24 |
| Last Update Date | 2021-04-14 |